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General NPI Number Information
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NPI Number | 1386326148
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Entity Type | Individual
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Provider Name | EMMA THERESE DONNELLY
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Gender | Female
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 725 IRVING AVE STE 804
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City | SYRACUSE
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State | NY
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Zip | 13210-1612
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Country | US
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Telephone | 315-214-7700
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Fax | 315-214-7701
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Provider Business Mailing Address
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Address Line | 201 MELROSE AVE
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City | SYRACUSE
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State | NY
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Zip | 13206-3248
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Country | US
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Telephone | 585-747-1215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F383558-01
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License Number State | NY
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